| National Provider Identifier [NPI]: | 1962422063 |
| Last Name Of The Provider | SMITH |
| First Name Of The Provider | MALCOLM |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 MEDICAL PLAZA |
| Street Address 2 Of The Provider | #365,530,420,120 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 90095 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1126 |
| Number Of Medicare Beneficiaries | 434 |
| Total Submitted Charge Amount | 442564.91 |
| Total Medicare Allowed Amount | 126024.31 |
| Total Medicare Payment Amount | 98108.07 |
| Total Medicare Standardized Payment Amount | 92544.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 19 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 1499.91 |
| Total Drug Medicare AllowedAmount | 471.51 |
| Total Drug Medicare PaymentAmount | 462.07 |
| Total Drug Medicare Standardized Payment Amount | 462.07 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 1107 |
| Number Of Medicare Beneficiaries With Medical Services | 434 |
| Total Medical Submitted Charge Amount | 441065 |
| Total Medical Medicare Allowed Amount | 125552.8 |
| Total Medical Medicare Payment Amount | 97646 |
| Total Medical Medicare Standardized Payment Amount | 92082.68 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 58 |
| Number Of Beneficiaries Age 65 to 74 | 168 |
| Number Of Beneficiaries Age 75 to 84 | 117 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 238 |
| Number Of Male Beneficiaries | 196 |
| Number Of Non Hispanic White Beneficiaries | 284 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | 39 |
| Number Of Hispanic Beneficiaries | 50 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 290 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 144 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.4308 |